早产儿视网膜病1082例筛查报告及诊治分析

Objective To explore the early diagnosis and treatment of retinopathy of prematurity (ROP). Methods Totally premature infants with gestational ages of ＜ 34 weeks or a birth-weight ＜ 2 000 gwho were born in our hospital from July, 2004 to June, 2009, received ROP screen that was carried out by ophthalmologists with particular expertise in ROP using binocular indirect ophthalmoscope. The first screening began at 4 to 6 weeks postnatal age or 32 weeks of postconceptional age. The infants with threshold and prethreshold type Ⅰ ROP(severe) were treated with retinal laser photocoagulation. The infants with immature retinal blood vessels or stage 1 ～ 2 ROP or pre-threshold type Ⅱ ROP (mild) were followed up until retinal vessels are seen in zone Ⅲ or it gets to threshold and pre-threshold type Ⅰ ROP level. All clinical data were analyzed retrospectively. Results 1 082 of total 2 295 premature infants (47. 14% ) received ROP screening ia our department during the past5 years. 14. 23% ( 154/1 082) infants were diagnosed as ROP,the mild and severe ROP accounted for 7.94% (86/1 082) and 6. 28% (68/1 082) respectively. Six infants had to be rehospitalized as they developed into severe ROP during follow-up period. Of all the 68 infants with severe ROP,two infants with severe ROP were confirmed to be bilaterally blind because they had intermitted therapy for one year. Sixty-six infants ( 132 eyes) received various treatments. Sixty-three cases were treated with photocoagulation therapy alone. Of the remaining 3 infants with aggressive posterior ROP, two infants were injected intravitreously with antagonist of vascular endothelial growth factor (Avastin) and photocoagulation,One who was found retinal detachment after photocoagulation therapy alone and then treated with vitrectomy,was blind finally. The eyesight of total 65 infants were saved successfully, the success rate of treatment was 98.48% (65/66). During the surveillance period, none of the infants who had received photocoagulation died,but 10 infants died of the deterioration of the original disease before they were able to receive photocoagulation. Conclusion ROP screening is an effective measure to prevent the progression of ROP. Laser photocoagulation is a safe and effective method for the infants with severe ROP. Photocoagulation combined with Avastin can save the sight of the premature infants with aggressive posterior ROP.     

病人健康问卷-9在卒中抑郁患者中的信度和效度研究

目的评测病人健康问卷-9(patient health questionnaire-9,PHQ-9)在我国脑卒中人群中的信度和效度。方法由经过培训的4名调查员对156例脑卒中患者分别进行Beck抑郁自评量表(Beck depression inventory,BDI)和PHQ-9、汉密尔顿抑郁量表(Hamilton depression rating scale,HAMD)和世界卫生组织复合性国际诊断访谈表3.0(World Health Organization composite international diagnostic interview,WHO-CIDI3.0)的评测,分析PHQ-9应用于脑卒中患者的信度、效度。结果克朗巴赫α系数为0.8383,提示该量表内部一致性较好;条目与总分的相关系数为0.533～0.777(P<0.05),各条目间的相关系数为0.183～0.599,提示该量表内部一致性较好;PHQ-9的效标效度为0.599(P<0.01),提示该量表效标效度良好;PHQ-9与BDI的相关系数为0.803(P<0.01),与HAMD的相关系数为0.835(P<0.01),提示该量表结构效度良好。结论 PHQ-9具有良好的信度和效度,基本符合心理测量学标准,是评价卒中后抑郁的可靠、有效工具。     

健康体检人群乙型肝炎血清学流行病学分析

目的 了解接受体检的健康人群中乙型肝炎病毒（HBV）的流行病学特征及免疫学指标分布情况。方法 以2020年1月1日至12月31日在安阳市某医院进行健康体检的儿童及成年人作为研究对象,收集该人群年龄、性别及职业等资料并进行HBV血清学标志物检测,采用描述性分析方法该地区健康体检人群HBV免疫学指标进行分析。结果 纳入研究的10 784名健康体检者中,男性6 123人,女性4 661人,男女性别比为1.31∶1,其中曾经接种过乙肝疫苗的共4 248人,占39.39%。共有2 215人的检验结果为5项全阴,占20.54%,其中男性5项全阴者比例为21.68%,显著高于女性的18.64%（P<0.01）。HBsAg阳性率为11.75%,HBsAb阳性率为66.68%,HBeAg阳性率为0.80%,HBcAb阳性率为28.04%,HBeAb阳性率为18.54%。不同性别、年龄段的HBsAg、HBsAb、HBeAg、HBcAb阳性率差异均具有统计学意义（P<0.05或P<0.01）。不同职业调查对象HBsAg阳性率、HBsAb阳性率差异均有统计学意义（均P<0.01）。结论 安阳市健康体检者中HBsAg阳性率水平处于较高的水平,男性、农民和服务人员HBsAg阳性率较高,仍然有一部分人群为HBV的易感者,建议尽快接种乙肝疫苗并积极改善当地人群的HBV防控措施。     

Tivozanib

肿瘤的增长与扩散依赖于新血管的生成或血管的新生。血管内皮生长因子受体（VEGFR）能促进内皮细胞的增殖,增强血管的渗透性,是控制新生血管生成的重要调控因子之一。Tivozanib是一种新型高选择抑制VEGFR的喹唑啉脲类化合物,体内外实验表明本品具有显著的抗血管生成和抑制抗肿瘤生长的活性,目前对肾细胞癌的治疗正在进行Ⅲ期临床实验。     

肛门直肠疾病患者的临床心理护理

现代医学模式为社会-心理-生理模式。心理因素在疾病的发生、发展、治疗和预后方面有极大的影响力，在护理工作中不可忽视。当患者开始接触医护人员，医护人员的言行举止就会对病人产生影响，只有医护人员的良好的形象和专业服务才能取得患者的信任和合作。反之，则会出现不利的影响，甚至出现难以预料的情况。因此，医护人员必须有和蔼可亲的态度，巧妙的语言，让患者感到亲切和信赖。现将肛门直肠疾病患者的心理护理体会报告如下：     

祛斑美容胶囊对大鼠血清、脑组织中SOD和MDA含量的影响

1　材料和方法1.1　材料　西安医科大学实验动物中心提供的 SD大鼠 (合格证书为陕医动字 0 8- 0 0 5 ) ,体质量 (196± 12 ) g,雌雄兼用 .祛斑美容胶囊是由陕西省心脑血管病研究所附属德通医院提供 ,实验前配制成 2 0 0 g· L- 1的混悬液 ,冰箱贮存备用 .实验所使用的 Vit.E油剂由上海第九制药厂生产 (批号 :96 110 1) ;SOD测定试剂盒和 MDA测定试剂盒由南京建成生物工程研究所生产 .1.2　方法　对大鼠血清、脑 SOD活性和 MDA含量的影响 :选取体质量 (196± 12 ) g的 SD大鼠 6 0只 ,雌雄各半 ,随机分为 5组 ,分别为正常对照组、Vit.…     

徒手扩张阴道与向下按压会阴体结合保护会阴法的临床应用

目的探讨应用徒手扩张阴道与向下按压会阴体相结合保护会阴的临床应用效果。方法初产妇共160例,徒手扩张阴道与向下按压会阴体相结合保护会阴为观察组,常规向上内方托压会阴为对照组,观察两组会阴裂伤及行会阴切开术的情况。结果观察组Ⅰ°会阴裂伤比对照组增加,但会阴未裂伤和侧切率均低于比对照组,两组比较有显著差异,而Ⅱ°、Ⅲ°裂伤两组相比较无明显差异。结论正确评估产妇胎儿情况,应用徒手扩张阴道与向下按压会阴相结合保护会阴能有效降低会阴切开率,但不能完全取代会阴切开手术。     

代谢综合征痰湿证相关指标研究进展

代谢综合征（MS）是一种复杂的代谢紊乱症候群,中医辨证论治MS具有独特优势,精确的证候诊断是防治MS的重要前提。文章通过综述近十年来MS的辨证研究,发现其痰湿证占有主导地位,故重点探讨近年来MS痰湿证在症状体征、实验室指标、代谢组学、基因组学等方面的研究概况,以期为今后MS痰湿证的信息化诊断提供依据,从而更好地指导临床,提高其早期诊断和辨证分型的准确率。     

心可舒片改善射血分数保留心力衰竭大鼠心脏功能及其作用机制探讨

目的 观察心可舒片对射血分数保留心力衰竭(Heart failure with preserved ejection fraction, HFpEF)大鼠心脏结构和功能的影响。方法 将30只自发性高血压大鼠(Spontaneous hypertension rat, SHR)分为SHR组、HFpEF组、心可舒组(334.8 mg/kg),10只Wistar-Kyoto(WKY)大鼠为对照组。心可舒组给予相应药物灌胃,其余组给予等量生理盐水,连续4周。测量血压和心脏重量指数(Heart mass index, HMI);超声心动图检测大鼠左心房内径(Left atrial diameter, LAD)、室间隔厚度(Interventricular septal thickness, IVST)、左室舒张末期内径(Left ventricular end diastolic diameter, LVEDd)、左室舒张末期后壁厚度(Left ventricular posterior wall thickness, LVPWd)、E/A、E/E′等容舒张时间(Isovolumic relax...     

CEA和SF在鉴别良恶性胸腔积液中的意义

目的：探讨癌胚抗原（CEA）,铁蛋白（SF）在鉴别良恶性胸腔积液中的意义。方法：采用放射免疫法检测了57例胸腔积液患者胸水及血清中CEA,SF的含量并分析了胸水及血清中CEA的比值。结果：恶性胸腔积液患者胸水中CEA,SF含量明显高于良性胸腔积液,P＜0．001,且恶性胸腔积液患者胸水／血清CEA比值＞1．5,而良性胸腔积液其比值＜1．5,结论：检测胸腔积液患者胸水中及血清中CEA,SF水平对鉴别良恶性胸腔积液具有重要的临床意义。